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The impossible intubation--what next?

The Journal of Cardiovascular Surgery

|November 1, 1986

Summary

This summary is machine-generated.

Anesthesiologists used cardiopulmonary bypass to safely manage a patient with an obstructing substernal goiter and laryngeal spasm, enabling endotracheal intubation and subsequent goiter removal.

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Area of Science:

Anesthesiology
Cardiothoracic Surgery
Airway Management

Background:

Substernal goiters can obstruct the airway, complicating anesthesia and intubation.
Laryngeal spasm presents an additional challenge to securing the airway.

Observation:

A patient presented with an obstructing substernal goiter and laryngeal spasm, rendering endotracheal intubation impossible.
Standard intubation techniques were not feasible due to the airway obstruction.

Findings:

Cardiopulmonary bypass was successfully employed to facilitate safe anesthesia induction and endotracheal intubation.
This allowed for the subsequent surgical removal of the substernal goiter.

Implications:

Cardiopulmonary bypass is a viable rescue strategy for complex airway management scenarios involving substernal goiters.

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Alternative anesthetic techniques should be considered in patients with anticipated difficult airways.